Basic Information
| Provider Information | |||||||||
| NPI: | 1093944225 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NELSON | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BUTTKE | ||||||||
| OtherFirstName: | PATRICIA | ||||||||
| OtherMiddleName: | C | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2000B TRANS MOUNTAIN RD FL 3 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799113600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152158400 | ||||||||
| FaxNumber: | 9156129253 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 TRANS MOUNTAIN RD FL 3B | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799113601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152158400 | ||||||||
| FaxNumber: | 9156129253 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2009 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 0101248659 | VA | N | Allopathic & Osteopathic Physicians | General Practice | 207W00000X | R1596 | TX | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.